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Prognostic assessment of resected colorectal liver metastases integrating pathological features, RAS mutation and Immunoscore
Surgical resection of colorectal liver metastases combined with systemic treatment aims to maximize patient survival. However, recurrence rates are very high postsurgery. In order to assess patient prognosis after metastasis resection, we evaluated the main patho‐molecular and immune parameters of a...
Autores principales: | , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley & Sons, Inc.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7737782/ https://www.ncbi.nlm.nih.gov/pubmed/32902189 http://dx.doi.org/10.1002/cjp2.178 |
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author | Baldin, Pamela Van den Eynde, Marc Mlecnik, Bernhard Bindea, Gabriela Beniuga, Gabriela Carrasco, Javier Haicheur, Nacilla Marliot, Florence Lafontaine, Lucie Fredriksen, Tessa Lanthier, Nicolas Hubert, Catherine Navez, Benoît Huyghe, Nicolas Pagès, Franck Jouret‐Mourin, Anne Galon, Jérôme Komuta, Mina |
author_facet | Baldin, Pamela Van den Eynde, Marc Mlecnik, Bernhard Bindea, Gabriela Beniuga, Gabriela Carrasco, Javier Haicheur, Nacilla Marliot, Florence Lafontaine, Lucie Fredriksen, Tessa Lanthier, Nicolas Hubert, Catherine Navez, Benoît Huyghe, Nicolas Pagès, Franck Jouret‐Mourin, Anne Galon, Jérôme Komuta, Mina |
author_sort | Baldin, Pamela |
collection | PubMed |
description | Surgical resection of colorectal liver metastases combined with systemic treatment aims to maximize patient survival. However, recurrence rates are very high postsurgery. In order to assess patient prognosis after metastasis resection, we evaluated the main patho‐molecular and immune parameters of all surgical specimens. Two hundred twenty‐one patients who underwent, after different preoperative treatment, curative resection of 582 metastases were analyzed. Clinicopathological parameters, RAS tumor mutation, and the consensus Immunoscore (I) were assessed for all patients. Overall survival (OS) and time to relapse (TTR) were estimated using the Kaplan–Meier method and compared by log‐rank tests. Cox proportional hazard models were used for uni‐ and multivariate analysis. Immunoscore and clinicopathological parameters (number of metastases, surgical margin, histopathological growth pattern, and steatohepatitis) were associated with relapse in multivariate analysis. Overall, pathological score (PS) that combines relevant clinicopathological factors for relapse, and I, were prognostic for TTR (2‐year TTR rate PS 0–1: 49.8.% (95% CI: 42.2–58.8) versus PS 2–4: 20.9% (95% CI: 13.4–32.8), hazard ratio (HR) = 2.54 (95% CI: 1.82–3.53), p < 0.0000; and 2‐year TTR rate I 0: 25.7% (95% CI: 16.3–40.5) versus I 3–4: 60% (95% CI: 47.2–76.3), HR = 2.87 (95% CI: 1.73–4.75), p = 0.0000). Immunoscore was also prognostic for OS (HR [I 3–4 versus I 0] = 4.25, 95% CI: 1.95–9.23; p = 0.0001). Immunoscore (HR [I 3–4 versus I 0] = 0.27, 95% CI: 0.12–0.58; p = 0.0009) and RAS mutation (HR [mutated versus WT] = 1.66, 95% CI: 1.06–2.58; p = 0.0265) were significant for OS. In conclusion, PS including relevant clinicopathological parameters and Immunoscore permit stratification of stage IV colorectal cancer patient prognosis in terms of TTR and identify patients with higher risk of recurrence. Immunoscore remains the major prognostic factor for OS. |
format | Online Article Text |
id | pubmed-7737782 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley & Sons, Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-77377822020-12-18 Prognostic assessment of resected colorectal liver metastases integrating pathological features, RAS mutation and Immunoscore Baldin, Pamela Van den Eynde, Marc Mlecnik, Bernhard Bindea, Gabriela Beniuga, Gabriela Carrasco, Javier Haicheur, Nacilla Marliot, Florence Lafontaine, Lucie Fredriksen, Tessa Lanthier, Nicolas Hubert, Catherine Navez, Benoît Huyghe, Nicolas Pagès, Franck Jouret‐Mourin, Anne Galon, Jérôme Komuta, Mina J Pathol Clin Res Original Articles Surgical resection of colorectal liver metastases combined with systemic treatment aims to maximize patient survival. However, recurrence rates are very high postsurgery. In order to assess patient prognosis after metastasis resection, we evaluated the main patho‐molecular and immune parameters of all surgical specimens. Two hundred twenty‐one patients who underwent, after different preoperative treatment, curative resection of 582 metastases were analyzed. Clinicopathological parameters, RAS tumor mutation, and the consensus Immunoscore (I) were assessed for all patients. Overall survival (OS) and time to relapse (TTR) were estimated using the Kaplan–Meier method and compared by log‐rank tests. Cox proportional hazard models were used for uni‐ and multivariate analysis. Immunoscore and clinicopathological parameters (number of metastases, surgical margin, histopathological growth pattern, and steatohepatitis) were associated with relapse in multivariate analysis. Overall, pathological score (PS) that combines relevant clinicopathological factors for relapse, and I, were prognostic for TTR (2‐year TTR rate PS 0–1: 49.8.% (95% CI: 42.2–58.8) versus PS 2–4: 20.9% (95% CI: 13.4–32.8), hazard ratio (HR) = 2.54 (95% CI: 1.82–3.53), p < 0.0000; and 2‐year TTR rate I 0: 25.7% (95% CI: 16.3–40.5) versus I 3–4: 60% (95% CI: 47.2–76.3), HR = 2.87 (95% CI: 1.73–4.75), p = 0.0000). Immunoscore was also prognostic for OS (HR [I 3–4 versus I 0] = 4.25, 95% CI: 1.95–9.23; p = 0.0001). Immunoscore (HR [I 3–4 versus I 0] = 0.27, 95% CI: 0.12–0.58; p = 0.0009) and RAS mutation (HR [mutated versus WT] = 1.66, 95% CI: 1.06–2.58; p = 0.0265) were significant for OS. In conclusion, PS including relevant clinicopathological parameters and Immunoscore permit stratification of stage IV colorectal cancer patient prognosis in terms of TTR and identify patients with higher risk of recurrence. Immunoscore remains the major prognostic factor for OS. John Wiley & Sons, Inc. 2020-09-09 /pmc/articles/PMC7737782/ /pubmed/32902189 http://dx.doi.org/10.1002/cjp2.178 Text en © 2020 The Authors. The Journal of Pathology: Clinical Research published by The Pathological Society of Great Britain and Ireland and John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Original Articles Baldin, Pamela Van den Eynde, Marc Mlecnik, Bernhard Bindea, Gabriela Beniuga, Gabriela Carrasco, Javier Haicheur, Nacilla Marliot, Florence Lafontaine, Lucie Fredriksen, Tessa Lanthier, Nicolas Hubert, Catherine Navez, Benoît Huyghe, Nicolas Pagès, Franck Jouret‐Mourin, Anne Galon, Jérôme Komuta, Mina Prognostic assessment of resected colorectal liver metastases integrating pathological features, RAS mutation and Immunoscore |
title | Prognostic assessment of resected colorectal liver metastases integrating pathological features, RAS mutation and Immunoscore |
title_full | Prognostic assessment of resected colorectal liver metastases integrating pathological features, RAS mutation and Immunoscore |
title_fullStr | Prognostic assessment of resected colorectal liver metastases integrating pathological features, RAS mutation and Immunoscore |
title_full_unstemmed | Prognostic assessment of resected colorectal liver metastases integrating pathological features, RAS mutation and Immunoscore |
title_short | Prognostic assessment of resected colorectal liver metastases integrating pathological features, RAS mutation and Immunoscore |
title_sort | prognostic assessment of resected colorectal liver metastases integrating pathological features, ras mutation and immunoscore |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7737782/ https://www.ncbi.nlm.nih.gov/pubmed/32902189 http://dx.doi.org/10.1002/cjp2.178 |
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